Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I '1 COMMUNITY DEVELOPMENT Permit #: FPS2012 -00147
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/05/2012
Parcel: 2S112DC01400
Jurisdiction: Tigard
Site address: 15865 SW 74TH AVE 115
Project: Builder Services Group, Inc Subdivision: FANNO CREEK ACRE TRACTS Lot: 4
Project Description: Add (1) fire sprinkler head for new restroom.
Contractor: AFP SYSTEMS INC Owner: JDS LLC
19435 SW 129TH AVE CRITERION CREEKVIEW LLC
TUALATIN, OR 97062 ATTN JAMES A MEYER
PO BOX 6525
BEAVERTON, OR 97007
PHONE: 503 - 692 -9284 PHONE:
FAX: 503 - 692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - COM 09/05/2012 $53.78
12% State Surcharge - Building 09/05/2012 $6.45
Type of Use: COM Plan Review - Fire Life Safety - COM 09/05/2012 $21.51
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $81.74
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $600.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance r ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Ce er. Th. - rules are set forth in OAR 952 - 001 - 0010 through OAR 952 - 001 - 0090. You may obtain a copy of the rules
or irect questions to OU C : calli ,03.232.1987 or 1.800.332.2344. /_�■
I sued By: /1 ( , Permittee Signature: /hi ' pAl/
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Building Permit Applicati 'RECEIVED
Fire Protection System t FOR OFFICE USE a
City of Tigard S E P 5 2012 • Dat�B` y'/ �VA Permit N °.:. P5 . , /g - •60/S/
° 13125 SW Hall Blvd., Tigard, OR n� Plan Review
. e Phone: 503.639.4171 Fax: 503.9L9 tOFTIGARD Date/B . Other Permit: 13a Ag r:9 - DO /6
T I c i A tt n Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Judy ® See Page 2 for •
Internet: www.tigard or.gov Notified/Method: Supplemental Information
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0 New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
l i gitddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
''4- =•� _5-.:" ' =? indicated on this application.
.� - - work Indic
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TEGOR .O t S'l;�t CT H =��
❑ I- and 2- family dwelling WColnmerciaUndustrial
Valuation: S
❑ Accessory building ❑ Multi- family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
-_::ca -r,.x:. ,'i :. :; ,,,- _ - - -_ = - -r
=i.. Total number of floors:
- OBI'. M.
?�� O �Tis =� TO �IV G - ..?
Job site address: 15 qv; / 5 / et 4 V� New dwelling area: square feet •
-
City / State/ZIP: v L a� )7 Garage/carport area: square feet
Suite/bldgJapt. no.: ` S'1 f Project name: M1 Covered porch area: square feet
Cross street/directions to job site: 141 L b2- EI) !b P - - ' , iiP Deck area: square feet
IA e + i t rilIMP wrr Other structure area: square feet
i REQUIRED iat GOMictili L USE CIIECKUST
Subdivision: ` Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
; : =`- indicated on this application.
�:- _ _ -- work Ind ca PP
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Valuation: GOO S
Existing building arca: g1.i" square feet
New building area: v square feet
- Number
of stories:
>'r N mb
- � PROPIvRxll': OWNSR'<. - - � "� � N ..
Name: Type of construction:
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Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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Business name: 5 � f l S All contractors and subcontractors are required to be
Contact name: 3- C�a a /�� ` ( ( under ORS with the and may be required to Contractors e license Board
OItS 701 and may be required to be licensed in the
Address: I� ()Li 3 S / / I /Ike jurisdiction in which work is being performed. If the
City/ State/ZIP:`0 -� Z T1 7 ��s , i Y`� Oa applicant is exempt from licensing, the following reasons
W �' 8/' Fax: (� /� Z j I y g(fj n apply:
Phone: � t?'
E -mail: ; ..1 tae s 7 - - _
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Business name:
tfl1 r S : ; r; .;- fpleiireref er ,raYee ehid iile�` .. .:.,..:.
Permit fee: 55, 7 g
Address: it /, . / � Z9 141 ,tk e
K / State surcharge (12% of permit fee): �, �5
City/State/ZIP Q `.-„ . g q � FLS plan review (40% of permit fee):
a1, 51
Phone: (533) ,,.• 9 Z �t� Fax: (1P3) Gil j ,/1 ¢6 (Due upon application.)
CCB lie.: G. Total permit fees: $ (, 7 er
i ly ti t . Authorized signature: / � / Amount received: 8 l . '7 T his permit application expires if a permit Is not obtained
13=i' l r ll "'W111111•1111 Date: frr�� wwithin 180 days after It has been accepted as complete.
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Fee methodology set by Tri- County Building Industry
Service Board.
I:t Bui !dinglPermitslFPS- Permitiipp.doe 03/23/06 4404613T(11/02/COM/waa)